| Pattelar
tendon |
| (Abat et
al., 2016) |
Incline eccentric
squats (25° decline), single-leg |
Bodyweight
only |
3×/week |
3×15
reps |
Fixed (no
structured progression; until VISA-P ≥ 90) |
VISA-P |
Yes |
Group 1:
Electro-physiotherapy (US, Laser CO2, IFC, 3×/week ×
8w); Group 2: USGET (every 2w, 3 punctures, US-guided) |
None reported |
| (Bahr et
al., 2006) |
Decline-board
eccentric squats (25°), single-leg eccentric |
Bodyweight
→ backpack (5-kg increments) |
2×/day |
3×15
reps per session |
Load adjusted
to maintain pain 4–5/10 |
VISA, VAS |
Yes |
Group 2:
Open surgical debridement + postop rehab; Secondary surgery if training
failed |
None reported |
| (Biernat
et al., 2014) |
Decline-board
squats (25°), added unstable surface + functional training |
Bodyweight |
Daily (except
match/training days) |
3×15
reps (per leg) |
Progression
by unstable surface/ functional additions |
VAS (stop
if >4/10) |
Yes |
Control:
Volleyball training only |
None reported |
| (Breda et
al., 2021) |
Pain-provoking
EET, single-leg decline squat (25° board) |
Bodyweight
→ backpack weights |
2×/day |
3×15
reps |
Increase
load with backpack if pain ≤3/10 |
Pain ≥5/10
during exercise; ≤3/10 to progress |
Yes |
PTLE (progressive
tendon- loading: isometric → isotonic → plyometric →
sport-specific) |
None reported |
| (Cannell
et al., 2001) |
Drop squats,
rapid knee unlocking |
Bodyweight
→ hand weights (2–18 kg) |
5×/week |
3×20
reps |
Gradual increase
in weights; return-to-run progression |
Pain expected;
icing post-exercise |
Yes |
Leg extension/curl
(concentric, progressive 4.5–32 kg, 5×/week) |
None reported |
| (Cunha et
al., 2012) |
Decline squat
(25°), single-leg eccentric |
Squat bar
+ plates (5 kg increments) |
3×/week |
3×15
reps |
PG: max tolerated
pain; WP: pain-free |
PG: “max
pain possible”; WP: no pain |
Yes |
WP: same
protocol without pain allowed |
None reported |
| (Frohm et
al., 2007) |
Bromsman
device (eccentric overload) |
Up to 320
kg barbell (machine) |
2×/week
(supervised) |
~70
min/ session |
Load set
by device, real-time feedback |
VAS (stop
if >5) |
Yes |
Group II:
One-legged decline squat (25° board, 3×15 reps, backpack) |
None |
| (Jonsson
and Alfredson, 2005) |
25°
decline squats, 3×15 reps, twice daily |
Backpack
(gradual increase) |
2×/day |
90 reps/day |
Load increased
if pain-free |
Pain allowed,
increase load when pain eased |
Yes |
CT: Concentric
training |
4/9 tendons
in CT group dropped out due to pain |
| (Kongsgaard
et al., 2009) |
Decline squats,
3×15 reps, 2×/day |
Backpack
(gradual) |
2×/day |
90 reps/day |
Increase
with pain decrease |
VAS ≤
3–5 |
Yes |
CORT: Steroid
injections + eccentric |
None reported |
| (Knež
and Hudetz, 2023) |
Decline squats
(17° board) |
Backpack
(gradual increase) |
2×/day |
90 reps/day |
Increase
if pain tolerated |
VAS ≤
5 |
Yes |
25°
decline board |
No adverse
events |
| (Lee et al.,
2020) |
Decline squats
(25° board), 3×15 reps |
Bodyweight
→ backpack (+5 kg) |
2×/day |
90 reps/day |
Progress
if VAS 4–5; reduce if >6–7 |
VAS before/
after |
Yes |
ESWT +
eccentric |
None reported |
| (Niering
and Muehlbauer, 2023) |
Eccentric
squats (flat and decline board) + stretching |
80% concentric–
eccentric 1RM |
2–3×/week |
40–60
reps/week |
Adjust load
to fatigue |
VAS ≤
5 |
Yes |
ALT therapy
(balance, isometrics) |
None reported |
| (Ruffino
et al., 2021) |
Heavy slow
resistance: squats, leg press, hack squat |
15–6
RM progression |
3×/week |
4 sets/exercise |
Gradual load
increase |
Pain <4/10
post-exercise |
Yes |
Flywheel
training |
Muscle soreness
only |
| (Sánchez-Gómez
et al., 2022) |
Decline squats
+ HMB supplementation |
HMB 3 g/day |
2×/day |
30 reps/day |
Progression
if VAS <4 |
VAS <4
for progression |
Yes |
Placebo supplementation |
None reported |
| (Gómez
et al., 2023) |
Decline squats
(daily) |
Weight vest
(5 kg) if VAS <3 |
6×/week |
30 reps/day |
Increase
with vest if pain ≤3 |
VAS ≤3 |
No |
N/A |
Muscle soreness
only |
| (van Ark
et al., 2016) |
Isometric
vs isotonic leg extension |
80% MVC (iso),
80% 8RM (isoT) |
4×/week |
5×45s
(iso); 4×8 reps (isoT) |
Increase
load 2.5% weekly |
NRS |
Yes |
Isometric
vs isotonic |
None reported |
| (Visnes et
al., 2005) |
Decline squats
(25° board), 3×15 reps, 2×/day |
Bodyweight
→ backpack (+5 kg) |
2×/day |
90 reps/day |
Load increase
if pain ≤3–4; reduce if ≥6–7 |
Target pain
≈5/10 tolerated |
Yes |
Control:
training only |
None reported |
| (Young et
al., 2005) |
Decline vs
step squats |
Bodyweight
→ backpack (+5 kg) |
2×/day |
90 reps/day |
Decline:
add load if pain eased; Step: progress speed then load |
Decline:
moderate pain allowed; Step: minimal pain only |
Yes |
Step group |
None reported |
| Achilles
Tendon |
| (Alfredson
et al., 1998) |
Heel drops,
straight knee (gastroc) & bent knee (soleus); eccentric only |
Bodyweight
→ backpack weights → weight machine if needed |
2×/day,
7d/wk |
3×15
reps for each exercise (2 variations) |
Progressive
overload when pain subsided |
Pain VAS
during running |
Yes |
Surgical
treatment + postop rehab (12m follow-up) |
Muscle soreness
only |
| (Demir Benli
et al., 2022) |
Alfredson
protocol: 3×15 reps, 2×/day, 12w |
Bodyweight
→ backpack weights |
2×/day |
3×15
reps |
Progress
load if tolerated, pain <5/10 |
VAS |
Yes |
Group 2:
ESWT (4 weekly sessions) |
None reported |
| (Beyer et
al., 2015) |
Eccentric
heel drops (straight and bent knee) |
Bodyweight
→ backpack (1 kg every 2w) |
2×/day |
3×15
reps |
Gradual increase
as pain diminished |
VAS (during
activity) |
Yes |
Group 2:
HSR (3×/week, heavy resistance) |
One tendon
rupture (ECC group) |
| (Habets et
al., 2021) |
Alfredson
protocol (heel drops, straight + bent knee) |
Bodyweight
→ backpack (+5 kg) |
2×/day |
180 reps/day |
Load increased
when pain-free |
Pain allowed
unless disabling |
Yes |
SG: Silbernagel
program (concentric–eccentric progression + plyometrics) |
One dropout
(SG group) |
| (Knobloch
et al., 2007) |
Eccentric
heel drops + AirHeel wrap |
Backpack
(5–10 kg) |
2×/day |
90 reps/day |
Load increase
if tolerated |
VAS ≤
5 |
Yes |
Eccentric
only (no AirHeel) |
None reported |
| (Knobloch
et al., 2008) |
Same as above |
Backpack
(5–10 kg) |
2×/day |
90 reps/day |
Load increase
if tolerated |
VAS ≤
5 |
Yes |
Eccentric
only (no AirHeel) |
None reported |
| (Langberg
et al., 2007) |
Heel drops
(straight/ bent knee) |
Backpack
(+20% BW) |
2×/day |
90 reps/day |
Increase
if tolerated |
VAS ≤
3–5 |
Yes |
Healthy tendon
comparison |
None reported |
| (Malliaras
et al., 2013) |
Standard
eccentric (80% concentric–eccentric 1RM) vs high-load eccentric (80%
eccentric 1RM) |
80% 1RM |
3×/week |
45–60
reps/week |
Load adjusted
to fatigue |
Pain monitored;
stop if intolerable |
Yes |
Control:
no exercise |
None reported |
| (Radovanović
et al., 2022) |
Alfredson
protocol vs high-load isometric plantarflexion |
Alfredson:
progressive load (5 kg/wk) |
2×/day |
45 reps/day
(Alfredson); 4×4 reps (High-load) |
Load progression
if NRS <6, exertion <3 |
NRS |
Yes |
Passive therapy
(no loading) |
None reported |
| (Rompe et
al., 2007) |
Heel drops,
3×15 reps, twice daily |
Bodyweight
→ backpack (5 kg) |
2×/day |
45 reps/day |
Load increased
when pain subsided |
Pain should
remain mild/moderate |
Yes |
SWT (radial
shock-wave therapy) |
None reported |
| (Rompe et
al., 2009) |
Heel
drops, 3×15 reps, twice daily |
Bodyweight
→ 5 kg rucksack |
2×/day |
45
reps/day |
Load
increased when pain subsided |
Pain
mild/ moderate only |
Yes |
Eccentric
+ SWT |
None
reported |
| (Stergioulas
et al., 2008) |
Decline squats
(progress to backpack load) |
Weight vest
(4 kg) |
4×/week |
144 reps/week |
Progress
load if VAS <50 mm |
VAS <50
mm |
Yes |
Placebo laser |
None reported |
| Hamstring
tendon |
| (Verma et
al., 2022) |
HPLT monotherapy |
Laser (50
J/cm2, 5W) |
3×/week |
6 min/session |
Fixed (dose-based) |
NPRS |
Yes |
Conventional:
US + heat + Nordic hamstring eccentrics |
None reported |